Prevalence of Anxiety Among Medical, Dental, and Nursing Students in Selected Balkan Countries: A Systematic Review and Meta-Analysis

Background: Anxiety is common among health science students, but the Balkan region is underrepresented in student mental health research and no regional synthesis exists. This systematic review and meta-analysis estimated the pooled prevalence of anxiety among medical, dental and nursing students in selected Balkan countries. Methods: Following PRISMA 2020 and a PROSPERO registration (CRD420261332221), PubMed, Scopus, and Web of Science were searched for English-language observational studies in eleven Balkan countries that assessed anxiety with a validated instrument. Two reviewers independently screened studies, extracted data and appraised quality (JBI). Prevalence was pooled with a DerSimonian-Laird random-effects model after Freeman-Tukey transformation, with prediction intervals and exploratory subgroup and sensitivity analyses. Results: Nine cross-sectional studies (N = 5177) from Croatia, Romania, Greece, Kosovo and Serbia were included. The pooled prevalence of anxiety at or above moderate severity was 27.5% (95% CI: 20.2–35.5%), with very high heterogeneity (I2 = 97.1%; 95% prediction interval 5.3–58.6%). Leave-one-out analyses (26.0–29.4%) and alternative estimators (26.9–27.5%) gave similar estimates. Subgroup analyses were exploratory. Conclusions: The pooled prevalence is an average across heterogeneous studies, not a regional benchmark. The evidence is limited to English-language studies from five of eleven countries, and the findings are preliminary. Harmonised primary research is needed.